Food Trends and Popular Nutrition Advice Online - Implications for Public Health.

Objectives: Consumers routinely seek health and nutrition-related information from online sources, including social media platforms. This study identified popular online nutrition content to examine the advice and assess alignment with the Australian Guideline to Healthy Eating (AGHE).

Methods: We used Facebook page "likes" as an indicator of popularity to identify online nutrition and diet content. Websites and blogs associated with pages that had more than 100,000 Australian likes on 7th September 2017 were included. The dietary advice promoted was collected and compared with the AGHE across nine categories (Vegetables, Fruits, Legumes, Grains, Lean Meat, Dairy/Alternative, Fat, Sugar, Salt).

Results: Nine Facebook pages met the inclusion criteria. The four most-liked pages were hosted by celebrities. Only two pages and their associated websites had advice consistent with AGHE recommendations across all nine categories reviewed. The concept of "real food" was a popular theme online. While most sources advocated increasing vegetable consumption and reducing processed food, other advice was not evidence-based and frequently deviated from the AGHE.

Discussion: Health information seekers are exposed to a variety of online dietary information and lifestyle advice. While few public health goals are promoted, there are many contradictions, as well as deviations from the AGHE, which can create confusion among health information seekers. Public health organisations promoting AGHE on Facebook are few and not as popular.

Conclusion: Public health organisations need to be more engaged on popular internet platforms such as Facebook. The prevailing popular nutrition advice online may increase consumer confusion, scepticism and even avoidance of dietary advice. Proactive efforts are needed by public health organisations, in partnership social marketing experts, to create and share engaging and accurate nutrition content. Partnership with celebrities should be explored to improve reach and impact of evidence-based diet recommendations online.